Abnormal uterine bleeding is a common presenting complaints in the Gynaecology outpatient department in all age groups. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. Endometrial tissue can be collected by sampling procedure such as Dilatation and Curettage (D&C), endometrial biopsy, pippelle aspiration or Hysteroscopy which is considered as gold standard. Variety of causes are there for AUB including causes which can be structural and can be imaged or non-structural which can be detected by history and laboratory tests. In this study an attempt is made to find out the causes and categorize them as per FIGO system.
Aims and Objectives
1. To find out the causes of AUB in the reproductive age group.
2. To categorize the causes of AUB as per the FIGO system.
Methodology and outcome: The study comprises 350 women of reproductive age group with AUB attending outpatient Gynae department of SMIMS, from Jun 2019 to Nov 2019. They were assessed on the basis of structured history, physical examination, local pelvic examination, investigations, USG and endometrial histopathology. Cause of AUB was detected and treatment was given to the patient as appropriated by categorization done in agreement with the palm-COEIN classification put forward by FIGO.
Results: The most prevalent cause of AUB was ovulatory dysfunction (n=99, 28.2%). Next common cause was leiomyoma (n=90, 25.7%), followed by endometrial causes (n=52, 14.5%), adenomyosis (n=30, 8.5%), not yet classified (n=32, 9.7%), Malignancy & Hyperplasia (n=28, 8.1%), Polyp (n=9, 2.5%), Iatrogenic (n=7, 2.2%) and Coagulopathy (n=1, 0.3%).
Conclusion: Ovulatory dysfunction and leiomyoma stands in front as the aetiological factors for AUB followed by endometrial causes and adenomyosis. The palm-COEIN classification helps to categorize the cause of AUB in a practical way thereby effectively direct the correct treatment for AUB patients. It helps in streamlining the investigations and management. Utilizing the advanced investigations, a better definition of the factors in palm COEIN can be done which will increase the pickup rate in various groups.